Name:
Date:
Local Address
Local Phone
City, State, Zip
Primary Email Address
Permanent Address
Emergency
Name:
City, State, Zip
Number :
Relationship:
Student:
Yes
No
School Attending:
Year in school:
Major:
Have you ever taken a first aid class?
Yes
(when)
No
Have you ever taken a CPR class?
Yes
(when)
No
Have you ever taken a blood-borne pathogens course?
Yes
(when)
No
Volunteer positions are always available. Paid positions open up from time to time, usually with a new semester. Several of our volunteers, over the years, have later become employees.
How are you interested in working with the BOAST program?
paid position
volunteer
student mentor
tutor
What will be your transportation to Kenwood Elementary School?
Car
Bus
Other
What interests you about working with children?
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